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I was wide-awake by this time and my body was starting to feel the exhilaration that precedes going to the unknown. It is a tension at the center of the stomach that doesn't disappear until the first cut has been made. When the action begins, the focus is on the patient and the patient only. My feelings are irrelevant. There's no room for your stomach to turn anxious somersaults in the OR.

Has anyone ever tried to write about all those feelings that go on in the surgeon's mind while he is scrubbing for the operation? I wish I could, but like my dreams the presence of creative thought is erased. One minute a brilliant and creative monologue. The next minute it's sucked into the vacuum of surgical criticality.

I turned right off Fourth Avenue onto Ninth Street and then into the hospital doctors' parking lot. I inserted the electronic card, and the railing opened up. The lot for the attending physicians was empty now, but not for long. It would soon be filled with cars branded Mercedes Benz, BMW, Lexus, and of course the customary large jeeps and SUVs whose farthest off road trek would be crossing a grassy median. I cast another glance at my watch as I rushed towards the OR from the physicians' parkade. Forty-three minutes.

On time.

Steam rose from the sink as hot water rushed in. Our dedicated resident Pavel Radezki and I watched the patient being put to sleep behind the glass wall and discussed the planned procedure as we washed our hands. I was calm, my neck muscles relaxed and the movements of my hands smooth. It is always the same: once the action approaches, the resentment of being bothered in the middle of the night is forgotten. Then, I'm eager to get started, sensing none of the usual tension I'd feel when scrubbing during the day for a major elective case.